Conventional 2DRT uses 2 parallel beams with opposite directions (anteroposterior and posteroanterior)
Currently reserved for palliative treatment of painful bone metastases and hemoptysis
New RT techniques developed to ↑ dose to target lesion and ↓ dose to surrounding structures
3D image reconstructed from CT data used to determine target volume; multiple beams used to conform to target and deliver maximal radiation to neoplasm
3D conformal RT (3DCRT): Each radiation beam shaped to fit profile of target volume (previously, radiation treatment matched height and width of target lesion)
4D conformal RT uses respiratory gating
Intensity-modulated RT (IMRT): Next generation of 3DCRT; allows more precise conformation to 3D shape by modulating intensity of radiation beam in multiple small volumes
Stereotactic body RT (SBRT): Small number of fractions (hypofractionated) with higher dose per fraction to treat early non-small cell lung cancer (NSCLC)
Proton therapy: Use of protons as radiation source
Radiation delivered to certain depth with minimal dose beyond target lesion; useful for treatment of recurrent previously irradiated tumors, central tumors, and tumors close to critical structures
IMAGING
General Features
Radiographic Findings
CT Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Benveniste MF et al: Recognizing radiation therapy-related complications in the chest. Radiographics. 39(2):344-66, 2019
Zhu X et al: Radiation-induced lung injury patterns and the misdiagnosis after SBRT of lung cancer. Eur J Radiol. 121:108708, 2019
Benveniste MF et al: Lung cancer: posttreatment imaging: radiation therapy and imaging findings. Radiol Clin North Am. 56(3):471-83, 2018
Febbo JA et al: Stereotactic body radiation therapy for early-stage non-small cell lung cancer: a primer for radiologists. Radiographics. 38(5):1312-36, 2018
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Radiation-induced lung disease (RILD)
Synonyms
Radiation pneumonitis
Radiation fibrosis
Definitions
Radiation therapy (RT) uses ionizing radiation to control cell growth by damaging DNA of cancerous tissue leading to cellular death
Conventional 2DRT uses 2 parallel beams with opposite directions (anteroposterior and posteroanterior)
Currently reserved for palliative treatment of painful bone metastases and hemoptysis
New RT techniques developed to ↑ dose to target lesion and ↓ dose to surrounding structures
3D image reconstructed from CT data used to determine target volume; multiple beams used to conform to target and deliver maximal radiation to neoplasm
3D conformal RT (3DCRT): Each radiation beam shaped to fit profile of target volume (previously, radiation treatment matched height and width of target lesion)
4D conformal RT uses respiratory gating
Intensity-modulated RT (IMRT): Next generation of 3DCRT; allows more precise conformation to 3D shape by modulating intensity of radiation beam in multiple small volumes
Stereotactic body RT (SBRT): Small number of fractions (hypofractionated) with higher dose per fraction to treat early non-small cell lung cancer (NSCLC)
Proton therapy: Use of protons as radiation source
Radiation delivered to certain depth with minimal dose beyond target lesion; useful for treatment of recurrent previously irradiated tumors, central tumors, and tumors close to critical structures
IMAGING
General Features
Radiographic Findings
CT Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Benveniste MF et al: Recognizing radiation therapy-related complications in the chest. Radiographics. 39(2):344-66, 2019
Zhu X et al: Radiation-induced lung injury patterns and the misdiagnosis after SBRT of lung cancer. Eur J Radiol. 121:108708, 2019
Benveniste MF et al: Lung cancer: posttreatment imaging: radiation therapy and imaging findings. Radiol Clin North Am. 56(3):471-83, 2018
Febbo JA et al: Stereotactic body radiation therapy for early-stage non-small cell lung cancer: a primer for radiologists. Radiographics. 38(5):1312-36, 2018
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